Authorized Representatives
You may designate an authorized representative, such as
your spouse, to complete the claim form for you if you are
unable to complete the form. A form can be obtained from
the MILA Fund Office or the applicable Claim Administrator
to designate an authorized representative. The Plan
may request additional information to verify that this
person is authorized to act on your behalf. A health care
professional with knowledge of your medical condition
may act as an authorized representative in connection with
an Urgent Care Claim (defined in the next column) without
you having to complete the special authorization form.
